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HomeMy WebLinkAboutBuilding Permit ApplicationAIJ APPLICABLE INFO MUST BE COMPL�t-r D FOR APPLICATION TO BE ACCEPTED _ Permit Number: Date: Sir. [LUM Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION. FOR: 49Gk1 I. WI-vVt,t1V6- ft L i IPATI0 ,PROPOSED IMPROVEMENT LOCATION Address: �1C-R 1 M ©l r+rj /3tNiJ I- T- -- P_ (EPCC FL a`J96 I PropertyTax ID #: 1:3 GZ f5rC 0021 CC)(p D Lot No. Site Plan Name: • MS■ :_: :� a Zk- New Electrical Meter Second Electrical Meter. CO'NSTRUC°TION INFORMATION Additional work to be performed under this permit- check all that apply: Block No. _Mechanical _ Gas Tank _ Gas Piping —Shutters . Windows/Doors _ Pond _ Electric GPfumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construct' n:o Cost of Construction: l 6 / Z9U • Ou ,D Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: OWNER/LE=SSEE: -r7 =CONTRACTOR Name��� F RP TO-- Name: A� T. Address:i s4 0%*ZGib�Y) C-Z Company: A)AFjj EE442, City: State: 8-= Address: (0 (l �/�fL( `.-�Ai g-0 Zip Code: ?i �f 1 f�) Fax: City: -FN2J R ceV State:r�L Phone No. 7221 %1�2� Zip Code: �iLlg4S( Fax: E-Mail: R�C��iffl 1pfca> Phone No �® j Fill in fee simple Title Holder on next page ( if different E-Mail L= from the Owner listed above) State or County License G If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL'CO`NSTR,, lJQN LIEN LAW INFO9aIVIaAT10"N DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: of Applicable Name: �'IDIil \lNri Name: __ZN Address: t3f-j ISi-L= 08-0 [Zs b(Z lA3i}Y Address: City: PRt,,pyL 9V-_-7State: �— City: State: Zip: Phone ��`a t Lia Zip: Phone: FEE SIMPLE TITLE HOLDER: _ of Applicable BONDING.COMPANY: of Applicable Name: Name: Address: i Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to, build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attornev before commencing work or recording your Notice of Commencement. Signature of Owner/ Lesse /Contra Tbr-a Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTYOF Q� [xGr,0 COUNTY OF U.- wo UALiU Sworn (or affirmed) and subscribed before me of Swor to (or affirmed) and subscribed before me of Ph sical Presence or Online Notarization by ,/ Physical Presence or Online Notarization 7 day by this7uAdayof eoa . 2024 this of.effeO n Ada-" . 202p Name of person making state ent. Name of person making statement. Personally Known OR Produced Identification Personally Knowr� OR Produced Identification Type of Identification Type of Identification Produced Produced S natu of Notary Public- S tK rid ARWEN 0 ADAMS (Si tur&T Notary Pub ic- St iiAYpo4G. ARWEN DADAMS Nota Public - State of FIoMd Commission No. (Seamission k GG 272920 ??4 : Notary Public - State of Floilda �;' '�Cpymission # G 272920 ommission No. moo'. M Expires Oct oe rt,: My Comm. Expires Oct 31, 202 Bonded through National Notary Ass . 31, 2022 Bonded through National Notary Assn. . REVIEWS FRONT` ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/ b/ Lu